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[慢性心力衰竭患者的远程监测。哪种诊断结果可预防再次住院?]

[Telemonitoring in chronic heart failure patients. Which diagnostic finding prevents hospital readmission?].

作者信息

Zugck C, Nelles M, Frankenstein L, Schultz C, Helms T, Korb H, Katus H A, Remppis A

机构信息

Universitätsklinikum Heidelberg, Abteilung für Kardiologie, Angiologie und Pulmonologie, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.

出版信息

Herzschrittmacherther Elektrophysiol. 2005 Sep;16(3):176-82. doi: 10.1007/s00399-005-0476-7.

Abstract

Heart failure exhibits a significant clinical and health economic problem. The implementation of new therapeutic strategies favorably affecting the course of disease is still insufficient in day-to-day practice. Thus, the usage of telemedicine offers a central instrument for service and information, so that an optimized therapy can be achieved by consequent surveillance of the patient with chronic heart disease. Predefined vital parameters are automatically transmitted to the telemedicine center; if individually predefined limits are exceeded, therapeutic means are immediately initiated. For the patient, the center is attainable 24 h throughout the year in case he experiences cardio-pulmonary symptoms. This patient-oriented usage of technology should not replace the physician-patient relationship, but improves and supports the participation and self-management of patients. Furthermore, the results show that this technology can significantly reduce the amount of emergency physician services, hospital admissions and primary care physician visits, and displays for health economics purposes a clearly more cost-effective treatment strategy, while allowing for additional costs inherent to the system. The usage of telemonitoring in chronic heart failure patients may be a trendsetting form of care, which can be used to drastically optimize the information and data flow between patient, hospital and primary care physician individually and at any time.

摘要

心力衰竭是一个重大的临床和卫生经济问题。在日常实践中,对疾病进程产生有利影响的新治疗策略的实施仍然不足。因此,远程医疗的应用提供了一种核心的服务和信息工具,从而通过对慢性心脏病患者的持续监测实现优化治疗。预定义的生命参数会自动传输到远程医疗中心;如果超过了各自预定义的限值,治疗措施会立即启动。对于患者来说,全年24小时都可以联系到该中心,以防他出现心肺症状。这种以患者为导向的技术应用不应取代医患关系,而是改善并支持患者的参与和自我管理。此外,结果表明,这项技术可以显著减少急诊医生服务、住院和初级保健医生出诊的次数,从卫生经济学角度来看,它显示出一种明显更具成本效益的治疗策略,同时也考虑到了该系统固有的额外成本。在慢性心力衰竭患者中使用远程监测可能是一种引领潮流的护理形式,可用于在患者、医院和初级保健医生之间随时单独大幅优化信息和数据流。

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